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1. An international multicenter propensity-score matched and coarsened-exact matched analysis comparing robotic versus laparoscopic partial liver resections of the anterolateral segments

Author

Kadam P., Sutcliffe R. P., Scatton O., Sucandy I., Kingham T. P., Liu R., Choi G. H., Syn N. L., Gastaca M., Choi S. -H., Chiow A. K. H., Marino M. V., Efanov M., Lee J. -H., Chong C. C., Tang C. -N., Cheung T. -T., Pratschke J., Wang X., Campos R. R., Ivanecz A., Park J. O., Rotellar F., Fuks D., D'Hondt M., Han H. -S., Troisi R. I., Goh B. K. P., Chan C. -Y., Prieto M., Schotte H., De Meyere C., Lai E., Krenzien F., Schmelzle M., Montalti R., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. -S., Jang J. Y., Lim C., Labadie K. P., Lopez-Lopez V., Kadam, P., Sutcliffe, R. P., Scatton, O., Sucandy, I., Kingham, T. P., Liu, R., Choi, G. H., Syn, N. L., Gastaca, M., Choi, S. -H., Chiow, A. K. H., Marino, M. V., Efanov, M., Lee, J. -H., Chong, C. C., Tang, C. -N., Cheung, T. -T., Pratschke, J., Wang, X., Campos, R. R., Ivanecz, A., Park, J. O., Rotellar, F., Fuks, D., D'Hondt, M., Han, H. -S., Troisi, R. I., Goh, B. K. P., Chan, C. -Y., Prieto, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Montalti, R., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Lim, C., Labadie, K. P., and Lopez-Lopez, V.

Subjects
Carcinoma, Hepatocellular, robotic liver resection, Hepatology, Liver Neoplasms, anterolateral segment, laparoscopic liver resection, Length of Stay, Postoperative Complications, Robotic Surgical Procedures, Hepatectomy, Humans, Laparoscopy, Surgery, Propensity Score, Retrospective Studies, minimally invasive liver surgery
Abstract

Background: Robotic liver resections (RLR) may have the ability to address some of the drawbacks of laparoscopic liver resections (LLR) but few studies have done a head-to-head comparison of the outcomes after anterolateral segment resections by the two techniques. Methods: A retrospective study was conducted of 3202 patients who underwent minimally invasive LR of the anterolateral liver segments at 26 international centres from 2005 to 2020. Two thousand six hundred and six cases met study criteria of which there were 358 RLR and 1868 LLR cases. Perioperative outcomes were compared between the two groups using a 1:3 Propensity Score Matched (PSM) and 1:1 Coarsened Exact Matched (CEM) analysis. Results: Patients matched after 1:3 PSM (261 RLR vs 783 LLR) and 1:1 CEM (296 RLR vs 296 LLR) revealed no significant differences in length of stay, readmission rates, morbidity, mortality, and involvement of or close oncological margins. RLR surgeries were associated with significantly less blood loss (50 mL vs 100 ml, P

Published
2022

2. Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?

Author

Choi S. H., Chen K. -H., Syn N. L., Cipriani F., Cheung T. -T., Chiow A. K. H., Choi G. -H., Siow T. -F., Sucandy I., Marino M. V., Gastaca M., Chong C. C., Lee J. H., Ivanecz A., Mazzaferro V., Lopez-Ben S., Fondevila C., Rotellar F., Campos R. R., Efanov M., Kingham T. P., Sutcliffe R. P., Troisi R. I., Pratschke J., Wang X., D'Hondt M., Yong C. C., Levi Sandri G. B., Tang C. N., Ruzzenente A., Cherqui D., Ferrero A., Wakabayashi G., Scatton O., Aghayan D., Edwin B., Coelho F. F., Giuliante F., Liu R., Sijberden J., Abu Hilal M., Sugioka A., Long T. C. D., Fuks D., Aldrighetti L., Han H. -S., Goh B. K. P., Kang I., Jang J. Y., Chan C. -Y., D'Silva M., Schotte H., De Meyere C., Lai E., Krenzien F., Schmelzle M., Kadam P., Montalti R., Giglio M., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. -S., Prieto M., Lim C., Nghia P. P., Kojima M., Kato Y., Forchino F., Herman P., Kruger J. A. P., Saleh M., Pascual F., Dalla Valle B., Lopez-Lopez V., Casellas-Robert M., Giustizieri U., Citterio D., Mishima K., Fretland A. A., Ghotbi J., Ettorre G. M., Colasanti M., Guzman Y., Ardito F., Vani S., Wang H. -P., Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, F., Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, F., Vani, S., Wang, H. -P., Choi, Sung Hoon, Chen, Kuo-Hsin, Syn, Nicholas L, Cipriani, Federica, Cheung, Tan-To, Chiow, Adrian K H, Choi, Gi-Hong, Siow, Tiing-Foong, Sucandy, Iswanto, Marino, Marco V, Gastaca, Mikel, Chong, Charing C, Lee, Jae Hoon, Ivanecz, Arpad, Mazzaferro, Vincenzo, Lopez-Ben, Santiago, Fondevila, Constantino, Rotellar, Fernando, Campos, Ricardo Roble, Efanov, Mikhail, Kingham, T Peter, Sutcliffe, Robert P, Troisi, Roberto I, Pratschke, Johann, Wang, Xiaoying, D'Hondt, Mathieu, Yong, Chee Chien, Levi Sandri, Giovanni Battista, Tang, Chung Ngai, Ruzzenente, Andrea, Cherqui, Daniel, Ferrero, Alessandro, Wakabayashi, Go, Scatton, Olivier, Aghayan, Davit, Edwin, Bjørn, Coelho, Fabricio Ferreira, Giuliante, Felice, Liu, Rong, Sijberden, Jasper, Abu Hilal, Mohammad, Sugioka, Atsushi, Long, Tran Cong Duy, Fuks, David, Aldrighetti, Luca, Han, Ho-Seong, and Goh, Brian K P

Subjects
Carcinoma, Hepatocellular, Laparoscopic liver, Settore MED/18 - CHIRURGIA GENERALE, Operative Time, Liver Neoplasms, Carcinoma, Hepatocellular, Difficulty score, Length of Stay, Iwate, Laparoscopic hepatectomy, Right posterior sectionectomy, Treatment Outcome, Postoperative Complications, Humans, Hepatectomy, Surgery, Laparoscopy, Retrospective Studies
Abstract

Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. Results: The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle’s maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Conclusion: Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.

Published
2022

3. Staging accuracy of endoscopic ultrasound performed by nonexpert endosonographers in patients with resectable esophageal squamous cell carcinoma: is it possible?

Author

Lee, W. C., Lee, T. H., Jang, J. Y., Lee, J.-S., Cho, J. Y., Lee, J. S., Jeon, S. R., Kim, H. G., Kim, J.-O., and Cho, Y. K.

Subjects
DIAGNOSIS of esophageal cancer, SQUAMOUS cell carcinoma, ENDOSCOPIC ultrasonography, TERTIARY care, COMPARATIVE studies, RETROSPECTIVE studies
Abstract

The accuracy of endoscopic ultrasound ( EUS) is operator-dependent. According to learning curve study, the accuracy of EUS T-staging for esophageal cancer has been reported to be greater in an investigator who had performed at least 100 EUS examinations. We determined comparative study regarding T-staging accuracy of EUS for esophageal squamous cell carcinoma between expert and nonexpert endoscopic ultrasonographers. We retrospectively identified 73 consecutive patients with esophageal squamous cell carcinoma who underwent EUS and endoscopic mucosal resection, endoscopic submucosal dissection, or surgery. EUS was performed by expert ( Group 1) and nonexpert ( Group 2) endoscopic ultrasonographers in multitertiary hospitals. Groups 1 and 2 were 37 and 36 patients during 2005-2011, respectively. Forty-two patients (57.5%) of the overall patients underwent surgical exploration. Correct endoscopic ultrasonographic T-staging of Group 1 was observed in 34 (91.9%) patients, while that of Group 2 was observed in 26 (72.2%) patients. And there was significant difference in correct endoscopic ultrasonographic T-staging between Group 1 and Group 2 ( P = 0.035). The incorrect endoscopic ultrasonographic T-staging of Group 1 were three cases that were overstaging (8.1%), but in Group 2 there were seven overstaging (19.4%) and three understaging (8.3%). There was no significant difference in overstaging or understaging of incorrect endoscopic ultrasonographic T-staging between Group 1 and Group 2 ( P = 0.528). This study first provides evidence that endoscopic ultrasonographic T-staging of nonexpert endoscopic ultrasonographers was inferior to be correct, compared with that of expert endoscopic ultrasonographers. EUS staging for esophageal cancer should be performed by expert endoscopic ultrasonographers to provide appropriate management strategy. [ABSTRACT FROM AUTHOR]

Published
2015
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4. Changing trend in bile microbiology and antibiotic susceptibilities: over 12 years of experience.

Author

Kwon, W., Jang, J.-y., Kim, E.-c., Park, J., Han, I., Kang, M., and Kim, S.-w.

Subjects
ANTI-infective agents, ACADEMIC medical centers, BILE, CHI-squared test, FISHER exact test, MEDICAL records, MICROBIOLOGY, ENTEROCOCCAL infections, LOGISTIC regression analysis, RETROSPECTIVE studies, DATA analysis software
Abstract

Purpose: Rapidly changing medical environments may have changed the microbiology of infected bile. The aim of our study was to identify the changing trends in microorganisms in biliary infections and examine their susceptibilities against currently recommended antibiotics. Methods: Bile cultures taken between 1998 and 2010 at Seoul National University Hospital, a tertiary medical center, were retrospectively reviewed. From 1,403 patients, 3,425 microorganisms were isolated from 2,217 cultures. The cultures were then tested to determine the types of microorganisms and their antibiotic susceptibility. Results: The five most frequently isolated microorganisms were Enterococcus (22.7 %) followed by Escherichia (13.2 %), Pseudomonas (10.9 %), Klebsiella (10.3 %), and Enterobacter (7.2 %). The trend in annual incidence indicated a growing emergence of Enterococcus ( P < 0.001). Among Enterococcus, E. faecium acquired a dominant position (50.6 %), showing an increasing trend over the study period ( P = 0.026). The incidence of vancomycin-resistant Enterococcus also showed an increasing trend ( P < 0.001). Many of the commonly used antibiotics provided inadequate coverage for the more frequently encountered microorganisms. Multiple regression revealed that benign causes of obstruction and non-operative treatment harbor an increased risk for enterococcal growth ( P = 0.001 and P = 0.027, respectively). Conclusions: In contrast to earlier reports, we found that Enterococcus has emerged as the most frequently isolated microorganism from bile. The importance of enterococcal infection should be recognized, and currently recommended antibiotics need to be re-evaluated since in our bile cultures most provided inadequate coverage for the more frequently encountered microorganisms. The changes in the trends of microorganisms isolated from bile should be considered in cases where patients present with biliary obstruction. [ABSTRACT FROM AUTHOR]

Published
2013
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5. The influence of interval between conization and laparoscopic radical hysterectomy on the morbidity of patients with cervical cancer.

Author

Li, H., Jang, J. Y., Chen, K., and Shao, X. G.

Subjects
*HYSTERECTOMY, *CERVICAL cancer patients, *LAPAROSCOPIC surgery, *RETROSPECTIVE studies, *POSTOPERATIVE period, *SURGICAL complications, *LYMPH node surgery, *CONIZATION
Abstract

The article reports on a study related to evaluation of influence of interval between conization and laparoscopic radical hysterectomy (LRH) on cervical cancer (CC) patients' morbidity. It mentions that retrospective study of CC patients undergoing LRH and pelvic lymphadenectomy was conducted to study the correlation between postoperative sequelae and the intervals between conization and LRH. The results suggest that LRH is feasible for the treatment of CC patients with previous conization.

Published
2012

6. Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies: An international multicenter study

Author

Hao Ping Wang, Chee Chien Yong, Andrew G.R. Wu, Daniel Cherqui, Roberto I. Troisi, Federica Cipriani, Davit Aghayan, Marco V. Marino, Andrea Belli, Adrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Marco Vivarelli, Fabrizio Di Benedetto, Sung-Hoon Choi, Jae Hoon Lee, James O. Park, Mikel Gastaca, Constantino Fondevila, Mikhail Efanov, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Chung Ngai Tang, Charing C. Chong, Mathieu D’Hondt, Andrea Ruzzenente, Paolo Herman, T. Peter Kingham, Olivier Scatton, Rong Liu, Alessandro Ferrero, Giovanni Battista Levi Sandri, Olivier Soubrane, Alejandro Mejia, Santiago Lopez-Ben, Jasper Sijberden, Kazuteru Monden, Go Wakabayashi, Atsushi Sugioka, Tan-To Cheung, Tran Cong Duy Long, Bjorn Edwin, Ho-Seong Han, David Fuks, Luca Aldrighetti, Mohamed Abu Hilal, Brian K.P. Goh, Chung-Yip Chan, Nicholas Syn, Mikel Prieto, Henri Schotte, Celine De Meyere, Felix Krenzien, Moritz Schmelzle, Kit-Fai Lee, Diana Salimgereeva, Ruslan Alikhanov, Lip Seng Lee, Jae Young Jang, Kevin P. Labadie, Masayuki Kojima, Yutaro Kato, Asmund Avdem Fretland, Jacob Ghotbi, Fabricio Ferreira Coelho, Jaime Arthur Pirola Kruger, Victor Lopez-Lopez, Paolo Magistri, Bernardo Dalla Valle, Margarida Casellas I Robert, Kohei Mishima, Giuseppe Maria Ettorre, Federico Mocchegiani, Prashant Kadam, Franco Pascual, Mansour Saleh, Alessandro Mazzotta, Roberto Montalti, Mariano Giglio, Boram Lee, Mizelle D’Silva, Phan Phuoc Nghia, Chetana Lim, Qu Liu, Eric C. Lai, Wang, Hao Ping, Yong, Chee Chien, Wu, Andrew G R, Cherqui, Daniel, Troisi, Roberto I, Cipriani, Federica, Aghayan, Davit, Marino, Marco V, Belli, Andrea, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Vivarelli, Marco, Di Benedetto, Fabrizio, Choi, Sung-Hoon, Lee, Jae Hoon, Park, James O, Gastaca, Mikel, Fondevila, Constantino, Efanov, Mikhail, Rotellar, Fernando, Choi, Gi-Hong, Campos, Ricardo Roble, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Tang, Chung Ngai, Chong, Charing C, D'Hondt, Mathieu, Ruzzenente, Andrea, Herman, Paolo, Kingham, T Peter, Scatton, Olivier, Liu, Rong, Ferrero, Alessandro, Levi Sandri, Giovanni Battista, Soubrane, Olivier, Mejia, Alejandro, Lopez-Ben, Santiago, Sijberden, Jasper, Monden, Kazuteru, Wakabayashi, Go, Sugioka, Atsushi, Cheung, Tan-To, Long, Tran Cong Duy, Edwin, Bjorn, Han, Ho-Seong, Fuks, David, Aldrighetti, Luca, Abu Hilal, Mohamed, Goh, Brian K P, Wang, H. P., Yong, C. C., Wu, A. G. R., Cherqui, D., Troisi, R. I., Cipriani, F., Aghayan, D., Marino, M. V., Belli, A., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Vivarelli, M., Di Benedetto, F., Choi, S. -H., Lee, J. H., Park, J. O., Gastaca, M., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. N., Chong, C. C., D'Hondt, M., Ruzzenente, A., Herman, P., Kingham, T. P., Scatton, O., Liu, R., Ferrero, A., Levi Sandri, G. B., Soubrane, O., Mejia, A., Lopez-Ben, S., Sijberden, J., Monden, K., Wakabayashi, G., Sugioka, A., Cheung, T. -T., Long, T. C. D., Edwin, B., Han, H. -S., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Chan, C. -Y., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. S., Jang, J. Y., Labadie, K. P., Kojima, M., Kato, Y., Fretland, A. A., Ghotbi, J., Coelho, F. F., Pirola Kruger, J. A., Lopez-Lopez, V., Magistri, P., Valle, B. D., Casellas I Robert, M., Mishima, K., Ettorre, G. M., Mocchegiani, F., Kadam, P., Pascual, F., Saleh, M., Mazzotta, A., Montalti, R., Giglio, M., Lee, B., D'Silva, M., Nghia, P. P., Lim, C., Liu, Q., Lai, E. C., Graduate School, Surgery, and CCA - Cancer Treatment and Quality of Life

Subjects
Male, Operative Time, Length of Stay, Conversion to Open Surgery, Hepatectomy, Humans, Minimally Invasive Surgical Procedures, Postoperative Complications, Retrospective Studies, Treatment Outcome, Hypertension, Portal, Laparoscopy, Neoplasms, Hypertension, Surgery, Portal
Abstract

Background: Despite the rapid advances that minimally invasive liver resection has gained in recent decades, open conversion is still inevitable in some circumstances. In this study, we aimed to determine the risk factors for open conversion after minimally invasive left lateral sectionectomy, and its impact on perioperative outcomes. Methods: This is a post hoc analysis of 2,445 of 2,678 patients who underwent minimally invasive left lateral sectionectomy at 45 international centers between 2004 and 2020. Factors related to open conversion were analyzed via univariate and multivariate analyses. One-to-one propensity score matching was used to analyze outcomes after open conversion versus non-converted cases. Results: The open conversion rate was 69/2,445 (2.8%). On multivariate analyses, male gender (3.6% vs 1.8%, P = .011), presence of clinically significant portal hypertension (6.1% vs 2.6%, P = .009), and larger tumor size (50 mm vs 32 mm, P < .001) were identified as independent factors associated with open conversion. The most common reason for conversion was bleeding in 27/69 (39.1%) of cases. After propensity score matching (65 open conversion vs 65 completed via minimally invasive liver resection), the open conversion group was associated with increased operation time, blood transfusion rate, blood loss, and postoperative stay compared with cases completed via the minimally invasive approach. Conclusion: Male sex, portal hypertension, and larger tumor size were predictive factors of open conversion after minimally invasive left lateral sectionectomy. Open conversion was associated with inferior perioperative outcomes compared with non-converted cases.

Published
2022

7. Robotic versus laparoscopic distal pancreatectomy for upfront resectable pancreatic cancer: An international retrospective cohort study.

Author

Chen, J.W., Van Ramshorst, T., Lof, S., Boggi, U., Butturini, G., Dokmak, S., Edwin, B., Esposito, A., Forgione, A., Giardino, A., Jang, J.-Y., Keck, T., Manzoni, A., Marino, M., Pando Rau, E., Ricci, C., Soonawalla, Z., Souche, R., White, S., and Zerbi, A.

Subjects
*PANCREATIC cancer, *PANCREATECTOMY, *COHORT analysis, *RETROSPECTIVE studies, *ROBOTICS
Published
2021
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8. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

Author

Luca Frulloni, I Gomatos, O Messina, Raghubinder S. Gill, Paolo Giorgio Arcidiacono, Vinicius Jardim Campos, Myriam Delhaye, W J Lee, Roberto Girelli, J M Urman Fernandez, Isabella Frigerio, Massimiliano Bissolati, Wataru Kimura, M Concepcion-Martin, T Ikeura, Jong Ho Moon, J Y Jang, Alessandro Bersch Osvaldt, Darwin L. Conwell, Riccardo Manfredi, Claudio Bassi, Maria Rachele Angiolini, Bertrand Napoleon, M Del Chiaro, B Jais, Riccardo Casadei, L S Lee, Atif Zaheer, Woohyun Jung, Ralph H. Hruban, F Bolado, D Oh, Ralf Segersvärd, Martina Fontana, Laura Maggino, Eva C. Vaquero, B Sastre, M A Rios-Vives, S Y Song, Rupert W. Leong, Anna Caterina Milanetto, Stephen P. Pereira, Margaret G. Keane, Giuseppe Malleo, Kazuichi Okazaki, Anne Marie Lennon, D H Song, I Araujo Acuna, Robert A. Moran, G Aguero Garcete, Hua Wang, Philippe Lévy, Stefano Crippa, Kofi Oppong, Giovanni Marchegiani, Vinciane Rebours, Myung-Hwan Kim, K V Kopchak, Darren Pavey, Chang Moo Kang, Matthew T. Huggett, Roberto Salvia, Claudio Ricci, Giovanni Morana, B Bernier, Alessandro Zerbi, C. De Angelis, Christopher L. Wolfgang, C. Fernandez del Castillo, M Shinzeki, Cosimo Sperti, Alex Faccinetto, Gianpaolo Balzano, Ichiro Hirai, Mehdi Ouaissi, Massimo Falconi, Y Ha, M Spandre, K T Jang, William R. Brugge, John P. Neoptolemos, M C Petrone, H J Choi, Huapyong Kang, I Matsumoto, J Tang, S W Kim, L Pererva, Jais, B, Rebours, V, Malleo, G, Salvia, R, Fontana, M, Maggino, L, Bassi, C, Manfredi, R, Moran, R, Lennon, A M, Zaheer, A, Wolfgang, C, Hruban, R, Marchegiani, G, Fernández Del Castillo, C, Brugge, W, Ha, Y, Kim, M H, Oh, D, Hirai, I, Kimura, W, Jang, J Y, Kim, S W, Jung, W, Kang, H, Song, S Y, Kang, C M, Lee, W J, Crippa, S, Falconi, M, Gomatos, I, Neoptolemos, J, Milanetto, A C, Sperti, C, Ricci, C, Casadei, R, Bissolati, M, Balzano, G, Frigerio, I, Girelli, R, Delhaye, M, Bernier, B, Wang, H, Jang, K T, Song, D H, Huggett, M T, Oppong, K W, Pererva, L, Kopchak, K V, Del Chiaro, M, Segersvard, R, Lee, L S, Conwell, D, Osvaldt, A, Campos, V, Aguero Garcete, G, Napoleon, B, Matsumoto, I, Shinzeki, M, Bolado, F, Fernandez, J M Urman, Keane, M G, Pereira, S P, Acuna, I Araujo, Vaquero, E C, Angiolini, M R, Zerbi, A, Tang, J, Leong, R W, Faccinetto, A, Morana, G, Petrone, M C, Arcidiacono, P G, Moon, J H, Choi, H J, Gill, R S, Pavey, D, Ouaïssi, M, Sastre, B, Spandre, M, De Angelis, C G, Rios-Vives, M A, Concepcion-Martin, M, Ikeura, T, Okazaki, K, Frulloni, L, Messina, O, Lévy, P, Lennon, Am, Kim, Mh, Jang, Jy, Kim, Sw, Song, Sy, Kang, Cm, Lee, Wj, Milanetto, Ac, Jang, Kt, Song, Dh, Huggett, Mt, Oppong, Kw, Kopchak, Kv, Lee, L, Fernandez, Jm, Keane, Mg, Pereira, Sp, Acuna, Ia, Vaquero, Ec, Angiolini, Mr, Leong, Rw, Petrone, Mc, Arcidiacono, P. G., Moon, Jh, Choi, Hj, Gill, R, De Angelis, Cg, Rios-Vives, Ma, and Lévy, P.

Subjects
Male, Abdominal pain, Internationality, PANCREATIC SURGERY, PANCREATIC TUMOURS, Cystadenoma, Gastroenterology, 0302 clinical medicine, 80 and over, Medicine, Societies, Medical, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Aged, 80 and over, Cystadenoma, Serous, Middle Aged, Europe, Serous fluid, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, medicine.symptom, hormones, hormone substitutes, and hormone antagonists, Adult, medicine.medical_specialty, endocrine system, Adolescent, Pancreatic serous cystadenoma, Malignancy, Asymptomatic, Aged, Humans, Retrospective Studies, Young Adult, Pancreatic Neoplasms, 03 medical and health sciences, Internal medicine, Medical, business.industry, Serous, Retrospective cohort study, medicine.disease, Cystic Neoplasm, Surgery, stomatognathic diseases, nervous system, sense organs, business, Societies
Abstract

Objectives Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16–99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2–200)), 9% had resection beyond 1 year of follow-up (3 years (1–20), size at diagnosis: 25 mm (4–140)) and 39% had no surgery (3.6 years (1–23), 25.5 mm (1–200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN9s related mortality was 0.1% (n=1). Conclusions After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. Trial registration number IRB 00006477.

Published
2016

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